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NPI 1952879330

NPI 1952879330 : MY HUYNH RPH : LODI, CA

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General NPI Number Information
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    NPI Number           |    1952879330
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    Entity Type          |    Individual 
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    Provider Name        |    MY HUYNH RPH
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/05/2018
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    Last Update Date     |    11/05/2018
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Provider Practice Location Address
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    Address Line         |    2355 W KETTLEMAN LN 
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    City                 |    LODI
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    State                |    CA
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    Zip                  |    95242-4120
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    Country              |    US
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    Telephone            |    209-339-0232
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    10631 CORNERSTONE CIR 
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    City                 |    STOCKTON
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    State                |    CA
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    Zip                  |    95209-4205
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    Country              |    US
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    Telephone            |    120-935-1406
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    183500000X
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    Taxonomy Name        |    Pharmacist
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    License Number       |    79856
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    License Number State |    CA
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